| NPI | 1134460629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH A BERGER Owner 765-649-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 111N00000X Chiropractor | |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-03-07 |